Principle 7

Long-term survivors should have access to specialized follow-up clinics that focus on health promotion, disease prevention, rehabilitation, and identification of physiologic and psychosocial problems. Communication with the primary care physician must be maintained.

Principle 8

Systematic long-term follow-up should generate data that contribute to improvements in cancer therapies and decreases in morbidity.

Principle 9

The responsibility for appropriate long-term medical care must be shared by cancer survivors, their families, the oncology team, and primary care providers.

Principle 10

The provision of psychosocial services must be safeguarded and promoted. Persons diagnosed with cancer should receive psychosocial assessments at critical junctures along the continuum of cancer care to determine the availability of needed support and their ability to seek information and advocate on their own behalf.

Principle 11

Psychosocial research is integral to comprehensive cancer care, and as such, psychosocial outcome measures should be included in all future clinical trials. The importance of this research and its application and transfer to oncology care plans should be recognized and encouraged.

Principle 12

Cancer survivors, health care providers, and other key constituency groups must work together to increase public awareness; educate consumers, professionals, and public policy makers; develop guidelines and disseminate information; advocate for increased research funding; and articulate for and promote survivors' rights.


Quality Assurance: a Market Approach

Although individual consumers may not yet wield much clout in the health care marketplace, large private-sector purchasers are already doing so. Most nonelderly Americans recieve their health care insurance through an employer, and employers choose health care plans for their employees on the basis of price, benefits, quality, and service. A common metric for quality is

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